Do nuts and seed have a high acid load that could be bad for the kidneys?

Image Credit: Liji Jinaraj / Flickr

Do nuts and seed have a high acid load that could be bad for the kidneys?

Thank you for this informative video – have been cutting down on high oxalate foods in attempt to prevent another stone, but don’t want to cut out all those delicious dark leafys. Any idea where nuts/seeds/legumes fall along the LAKE scale?

ashelton / Originally posted in How to Treat Kidney Stones with Diet 


Great question! I had to look around a bit, but Dr. Greger and I found some information about the Load of Acid to Kidney (LAKE) scores of nuts and seeds. I even asked the author, Dr. Alberto Trinchieri, that Dr. Greger cites in his video. On a side note, my old boss, Dr. Barnard, used to tell me researchers are just lonely people just waiting to engage with someone. I thought he was crazy, until I actually started doing research myself. Well, after helping publish a few papers and taking this role at NutritionFacts I now realize I’m just another lonely soul looking to talk to anyone interested about nutrition! Anyway, the point is researchers love discussing their work and I appreciate the time Dr. Trinchieri took to write me. With his permission to repost he kindly answered the question for us:

“I had a look to your beautiful video on and I thank you for the citation of my work. About nuts and seeds, firstly it should be pointed out that a serving has a limited weight (about 1 oz or 30 gr) and that the recommended daily dose is about 1.5 oz. In fact they are highly caloric for their lipidic content.There are different types of nuts that have different potential effects on the acid load. Basically they have an high content in protein (but vegetal!!), calcium and potassium. The sum of the effects of these nutrients give a “neutral” effect in term of acid load (LAKE = 0). By example a serving of 25 grams of hazelnuts implies an acid load of – 0.7, 25 gr of peanuts of + 2.0, 25 grams of walnuts + 1.7. A mix of seeds and nuts can imply a load ranging 0 to 1. In conclusions a daily serving of 25-30 gr of nuts and seeds has a limited effect on LAKE score, therefore we decided to skip them from final computation. To be more precise they could be assimilated to the Legumes Group (really peanuts are legumes by themselves).”

Here is a link to the study about nuts and seeds and LAKE scores. Again, I want to thank Dr. Trinchieri  for his input. 

For more information about why nuts and seeds may be super healthful check out: How Do Nuts Prevent Sudden Cardiac Death? and Which Nut Fights Cancer Better? and Nuts May Help Prevent Death

Thanks, ashelton!

Image Credit Liji Jinaraj / Flickr


25 responses to “Do nuts and seed have a high acid load that could be bad for the kidneys?

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  1. Thank you for that information. For a patient with kidney failure and on dialysis, how are they able to maintain a vegan diet given that they have to avoid foods high in potassium and phosphate? What specific kind of diet/foods can they eat safely?

    1. Hi Sydney,
      I have been at Stage IV CKD due to TCC(transitional cell carcinoma), the surgical loss of a Kidney and a surgically corrected congenital Kidney malformation. Eating a Vegan/Vegetarian diet I have seen my remaining Kidney function go from 29% to 40% function. This was against all shared logic for a 58 yr. old person. Still my MD’s remark, “we aren’t sure of what I am doing, but keep doing it”. I am presently Stage III CKD and very active and healthy other than still fighting TCC. I have found the Potassium/Phosphorous loads from vegetable sources are easily handled by my body. It appears the fiber in a WFPB Diet pulls excess amounts of K and Phos through my system and even though the nutritional value of the foods I eat exceed recommended levels, I don’t experience excessive retention of these. There is more to my case and I am somewhat unique in the fact I have an Ileal Conduit and therefore dump electrolytes more readily than before my Baldder and Prostate were removed, again due to TCC. The fact remains, I have found that processed foods give you 100% of their value of K and Phos but the Whole Food Plant Based diet doesn’t. I used to agonize over mg’s of potassium in spinach, tomatoes, apricots and cantaloupe. Now I eat in moderation and balance and with as much variety as possible. The one thing to eliminate completely is dairy from your diet. It is completely un-necessary for your optimal health and with it your worries about Phosphorous.

  2. Hi Steve Tweito, I ran across this conversation just looking for as much info. as i could about health and my condition. I believe you answered one of my questions on cdk health it was can someone with stage iv cdk eat a PBD with potassium restriction I believe the answer is yes! Thank you!

  3. What is Dr. Gregors opinion or support for against these ketogenic diets? Fermented foods. I cant find anything by him on these controversial topics.

    1. Seeker2be: If you do a search on ketogenic, you will get 4 hits. Maybe one of those pages will be helpful. But even if those pages do not satisfy you, consider this: a ketogenic diet is especially high fat and low carb. In various videos on this site, we have seen Dr. Greger tell us about the healthy diet of the Okinawans which is the reverse: especially high carb and low fat. Also we have seen a lot of information about the negative effects of foods with saturated fat and the positive effects of foods high in carbohydrates. I think we can infer that Dr. Greger would not recommend a ketogenic diet for the average healthy person. (For someone with epilepsy, a ketogenic diet may help with seizures. But that doesn’t necessarily make it a healthy diet for everyone.) What do you think?
      As for fermented foods, Dr. Greger doesn’t look at them en-mass, but addresses some of them more specifically. So you might do a search on alcohol and kimchee, and sauerkraut, etc to see if you can get some of the answers you want.

  4. I am experiencing local (around descending colon or right kidney area) inflammation/mild discomfort. Deepest finger prodding has no effect at all. This has been going on for about three months. I have been mostly vegetarian for about a year and vegan since 3/15/16. Any thoughts on cause or healing?

  5. Hello,

    I have severe CAD, after reading many books and articles there seems to be a differing opinion as to the role that nuts/seeds should play in a disease reversal diet. The research regarding nuts seems very promising but some of the prominent names in cardiovascular disease recommend against nuts and seeds altogether. Were those recommendations made before the evidence on nuts was discovered? I have seen video’s in which Esselstyn has stated no nuts, not even a half of walnut? I adopted a vegan diet 1.5 years ago and had immediate results with my lipid profile. But I feel that I may be missing an important nutritional element by excluding nuts from my diet.


    1. Hi Bill — thanks for the question!

      The general health benefits of nuts are well established and there are many videos on this site on that topic.

      From your question, it seems like you are aware of this and you are wondering if you are missing out by avoiding nuts. I looked at a few studies and found no evidence that nuts should be avoided in CAD.

      This study saw no negative effects in patients with CAD. And this meta-analysis found that nuts can decrease CAD risk. The American Academy of Family Physicians makes the suggestion to ‘Eat moderate amounts of nuts that are rich in monounsaturated fat, like hazelnuts, almonds, pecans, cashews, walnuts, and macadamia nuts.’

      I agree that nuts are an important part of a WFPB lifestyle and see no reason to avoid them in CAD.

      I hope this helps!

  6. Hi doctor, i have a question. I took 2 pebbles of epsom salt and 100% rda of zinc on an empty stomach. after 6 months got panic attacks. those stopped when i stopped taking those. what was happening? thanks

  7. Are there any benefits in eating any type of animals beside insects and all that. For example I here that some people don’t put antibiotics in cows and that all of the sudden it makes it healthy to eat that cow. I just want to clear that up? I was told to post here I believe

    1. bob k: Following is my standard answer to this question. Here’s the conclusion up front: There may be *marginal* health advantages to an animal product raised
      “naturally”, but in the end, the main problems are inherent with the
      product themselves regardless of how the animal was treated.

      Dr. Don Forrester wrote:
      “[humans] are designed as “hind gut fermenting herbivores” a lot of data to support the anatomy and physiology of this hypothesis. Beyond that meat from grass fed animals also contains saturated fat which is metabolized to cholesterol and dioxins…see which are in the air as a product of burning plastics. It is true that grass fed animal meat is healthier then animals via CAFO’s but that doesn’t make it healthy.” … “[Some people may have] a similar argument about fish which is even easier to address see video…

      And Toxins also wrote an excellent reply:
      “endotoxins, xenoestrogens, increases in igf-1 and arachidonic acid. All are inherent components of meat whether organic or conventional.

      I would add saturated fat and cholesterol to the list of problems. Another point I like to make is that people who push meat like to talk about primitive cultures who ate mainly meat. Before modern times, those animals would have been more naturally raised or wild animals. And yet we have plenty of evidence that people eating those animals suffered bad health consequences by eating those animals. It’s not a 30 second sound-bite, but if someone wants to learn more about those arguments and counter-arguments, Plant Positive has a very scholarly and fully referenced set of videos on YouTube.

      Or you might check out the website by HealthyLongetivity. Here is a quote from that site:
      “I have already posted several articles describing the poor health of populations who subsisted predominantly on
      naturally raised animal foods which you can find below:

      Here is another quote from Healthy Longetivity:
      “It is well established that saturated fat (in specific lauric, myristic and palmitic acids) raises total and LDL cholesterol,
      and that LDL cholesterol is an established cause of cardiovascular disease. The cholesterol raising effects of saturated fat is not the result of how the animal was raised as tropical plant fats high in lauric, myristic and palmitic acids will also raise total and LDL cholesterol.

      As I previously pointed out, it has been demonstrated in thousands of animal experiments that the feeding of cholesterol and saturated fat, including in the form of fresh egg yolk accelerates the development of atherosclerosis in
      virtually every vertebrate species that has been sufficiently challenged. This includes mammalian, avian and fish species- herbivores, omnivores and carnivores, and over one dozen different species of nonhuman primates. Again this cannot be attributed to the way that the animal was raised as when taking into consideration the amount of antioxidants and carotenoids as well as the lack of cholesterol, tropical plant fats high in lauric, myristic and palmitic acids will also accelerate atherosclerosis in animals to a similar degree as
      saturated animal fats.

      It has been shown in controlled feeding trials that heme iron from meat causes the production of NOCs (N-nitroso compounds) in the digestive tract which in-turn causes DNA adducts in the human digestive tract. Therefore the heme
      iron content in meat rather than how the animal was raised can partly explain the positive association between red meat and colorectal cancer.

      *My* bottom line is: There may be *marginal* health advantages to an animal product raised “naturally”, but in the end, the main problems are inherent with the product themselves regardless of how the animal was treated.

      Hope that helps.

  8. Hi Doc,
    I’ve been adhering to a plant-based way of eating for some months now and have recently decided to incorporate: flaxseeds, DHA/EPA derived from algae and 2000 IU’s of vitamin D if I haven’t been exposed to the recommended amount of sunlight that day. I have a couple of questions on quality and dosing procedures:
    1. The DHA/EPA is a gel capsule with sunflower oil being listed as an ingredient. I’ve avoided all oils thus far and wasn’t sure if it would be a detriment?
    2. I take the flax and omegas at once, then later in the evening if I haven’t had sun exposure I’ll take the vitamin D with a little avocado being that D is fat soluble. Is my way of doing with these okay?

  9. I have been making Dr’s Gregers Seven Check-Mark Smoothie each morning and added two TBSP of Hempseeds this morning. But, my question is regarding another morning ritual, which is eating about a 2″ x 2″ square of a breakfast bar from THUG cookbook. I’d like to give you the ingredients and please tell me if it’s a good breakfast ritual. I have adjusted the recipe to make it healthier in my opinion as well. I’d appreciate your opinion.

    This makes a 13×9 pan and I cut them into squares about 2×2:
    2 cups rolled oats
    3/4 cup quinoa
    1/4 cup millet
    1/1/4 cups mixed nuts or seeds (I use equal amounts of pumpkin, sunflower and almonds)
    – I also add flaxmeal
    1/2 cup dried cranberries or other dried fruit
    1/4 tsp salt
    1/2 cup maple syrup (I substitute 1/2 Blackstrap Molasses)
    1/2 peanut butter
    1/4 cup refined coconut oil or olive oil (I have been using coconut)
    2 TBSP white or brown sugar (I use date sugar)
    1 tsp vanilla

    What do you think of the nutritional value of these “To Go Bars”? Thank you so much!

    1. gestobbe: I think your bars look pretty darn healthy. The only issue that really stands out for me is the oil. Could you try it without the oil and see if it works just as well? If not, maybe you could substitute something in place of the oil once you figure out what role the oil is playing.
      Don’t be surprised if I show up for breakfast at your house some day. ;-)

  10. I left this question somewhere on this website – or maybe on another. I’ve been obsessed for weeks with reading articles and research about food and nutrition. I happened upon while reading someone’s blog. I just watched Dr. Greger present information in the video Food As Medicine. Wow. I’m impressed. I used to be a vegetarian for about 15 years. That was 20 years ago. Recently I’ve read about Paleo, Whole30 diets. I don’t really believe in big ol’ meat plan. But, I modified my own 30 day reset: no sugar, no packaged or processed foods – with few exceptions, no alcohol – but I did use the Whole30 list for shopping. Now after watching the video – I’m conflicted. I have expensive Bone Broth simmering on the stove, I have recently purchased meat and chicken and it’s in the freezer. All set to prep meals eliminating legumes and grains per Whole30 and a Dr. Gundry who says the 4 fake foods are foods high in LECTIN: 1. tomatoes 2. beans 3. cashews as he says are really beans – (so does a moderator or Dr on this site ) 4. Grains
    He lists many fruits and veggies high in lectin but says we need to eat some fruits and veggies. Dr. Gundry says out with nuts and seeds except for walnuts, pistachios, macadamias. And males should not eat peanuts. OH MY GOSH what are we supposed to eat? Dr. Gerger’s video is very compelling. But what about the lectin in legumes and fruit and grains – in which Dr. Gundry says is not adequately destroyed. (Soaking destroys some maybe most of the lectin in some beans). There is a question in here somewhere.

    I guess to narrow my thoughts: What is Dr. Greger’s answer to the statement: don’t eat grains and legumes – because of the lectin?

  11. I am reading “How Not to Die” and am interested in trying some of the nuts, i.e.,brazil nuts to try to control cholestrol, etc. I did not see where the Dr. made a distinction on whether the nuts you eat have to be raw, or can they be roasted? I am assuming raw, but wanted to see how others interpreted it.

  12. My son has Been diagnosed with c3gn a very serious kidney condition. He is 22 years old,At stage 3 kidney disease, otherwise very athletic and fit but is now on lots of medication and has been told to keep potassium etc.Low and his veg To only 4 portions of vegetables a day. He’s a meat eater and salad dodger! I feel this isn’t helping at all. What kind of diet should he follow? He needs a lot of calories but he’s very restricted in what he can eat. The advice given to him by dieticians is very counter intuitive for me.

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